title: The cost of resident scholarly activity and its effect on resident clinical experience.
abstract: BACKGROUND
  Scholarly activity is an important aspect of the academic training of future anesthesiologists. However, residents' scholarly activity may reduce training caseloads and increase departmental costs.
  
  
  METHODS
  We conducted this study within a large academic anesthesiology residency program with data from the 4 graduating classes of 2009 through 2012. Scholarly activity included peer-reviewed manuscripts, case reports, poster presentations at conferences, book chapters, or any other publications. It was not distinguished whether a resident was the principal investigator or a coinvestigator on a project. The following data were collected on each resident: months spent on a resident research rotation, number of scholarly projects completed, number of research conferences attended, and Accreditation Council for Graduate Medical Education case entries. Comparison was made between residents electing a resident research rotation with those who did not for (1) scholarly projects, (2) research conference attendance, and (3) Accreditation Council for Graduate Medical Education case numbers. Cost to the department for extra clinical coverage during residents' time spent on research activities was calculated using an estimated average cost of $675 ± $176 (mean ± SD) per day with local certified registered nurse anesthetist pay scales.
  
  
  RESULTS
  Sixty-eight residents were included in the analyses. Twenty-four residents (35.3%) completed resident research rotations with an average duration of 3.7 months. Residents who elected resident research rotations completed more scholarly projects (5 projects [4-6]: median [25%-75% interquartile range] vs 2 [0-3]; P < 0.0001), attended more research conferences (2 conferences [2-4] vs 1 [0-2]; P < 0.0001), but experienced fewer cases (980 cases [886-1333] vs 1182 [930-1420]; P ≤ 0.002) compared with those who did not elect resident research rotations. The estimated average cost to the department per resident who elected a resident research rotation was $13,500 ± $9724 per month. The average resident time length away from duty for conference attendance was 3.2 ± 0.2 days, with an average cost to the department of $2160 ± $565. The average annual departmental expense for resident conference travel was an additional $1424 ± $133 per resident, as calculated from reimbursement data. Together, the estimated departmental cost for resident scholarly activity during the residency training period was $27,467 ± $20,153 per resident.
  
  
  CONCLUSIONS
  Residents' scholarly activities require significant departmental financial support. Residents who elected to spend months conducting research completed significantly more scholarly projects but experienced fewer clinical cases.
authors.affiliation: From the *Department of Anesthesiology, University of Pittsburgh Medical Center; and †Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Schott
authors.forename: Trent D
authors.initials: TD
authors.lastname: Emerick
authors.forename: David G
authors.initials: DG
authors.lastname: Metro
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000193:education*; D004503:Education, Medical, Graduate / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000191:economics / Q000379:methods*; D008297:Male; D010414:Pennsylvania; D012106:Research / Q000191:economics*; D012577:Schools, Medical; D013997:Time Factors